Cms-10-qp-14-f8-drivers' Daily Worksheet, Checklist

Driver Fatigue Self-Assessment

• Do you struggle to keep your head up?

  Yes

  No

• Are your eyelids drooping, or your eyes going out of focus?

  Yes

  No

• Are you relying on caffeine for alertness?

  Yes

  No

• Have you been missing exits or road signs?

  Yes

  No

• Have you been braking late or slowing unintentionally?

  Yes

  No

• Is your mind wandering?

  Yes

  No

• Has the rest since your last shift been inadequate?

  Yes

  No

• Remember, fatigue is the number one contributor of heavy vehicle accidents. It's not worth the risk.

Fitness for Work

• Sign to Declare that you are (1) not under the influence of alcohol, drugs or fatigue, and (2) not suffering from physical, medical or psychological conditions which may impair your ability to drive or make decisions.

  Sign

• NOTE: If you detect symptoms of fatigue during self-assessment, extend your rest break. If detected during transport, you must stop all driving activities as soon as safely practicable and rest. Notify your supervisor and make arrangements as required.

Personal Equipment and First Aid

• First Aid Kit

  Compliant

  Non-Compliant

  N/A

• 250mL eye wash kit (FULL)

  Compliant

  Non-Compliant

  N/A

• PPE, DG safety gear - long sleeves and pants

  Compliant

  Non-Compliant

  N/A

• Thermally insulated gloves (DG 2.1, 2.2)

  Compliant

  Non-Compliant

  N/A

• Serviceable safety triangle / roadside diamonds

  Compliant

  Non-Compliant

  N/A

DG Class 6.1

• Chemical Gloves

  Yes

  No

  N/A

• Resistant Overalls

  Yes

  No

  N/A

• Chemical Resistant Boots

  Yes

  No

  N/A

Daily Operations Report

• Full Name

• Registration

• Start Time

  Date

• Finish Time

  Date
Rest Breaks

• Start

  Date

• Finish

  Date
• Location
  Address

Vehicle Details

• Speedometer Finish

• Speedometer Start

• KM travelled

• Driver's Signature

  Sign
Deliveries not Completed

• Deliveries not completed

• Comments

• Signature

  Sign

• Fleet Number

• Are you Fatigued

  Yes

  No

• How many hours have you been driving for?

• Have you notified your manager

  Yes

  No

  N/A

Vehicle Mechanical

• Coolant Level

• Oil level

• Indicators/lights working

  Yes

  No

  N/A

• Are there leaks (under truck)

  Yes

  No

  N/A

• Load restraint devices - inspected and in good working condition

  Yes

  No

  N/A

• Reverse warning beeper

  Yes

  No

  N/A

• Windscreen wipers

  Compliant

  Non-Compliant

  N/A

• Horn

  Compliant

  Non-Compliant

  N/A

• Truck keys returned/in place (as req'd)

  Yes

  No

  N/A

• Visual checks on suspension

  Yes

  No

  N/A

• Customer keys returned (as req'd)

  Yes

  No

  N/A

• Fuel level

  Yes

  No

  N/A

• Tyres - tread, pressure good

  Yes

  No

  N/A

• Handheld returned

  Yes

  No

  N/A

Ancillary Equipment

• DG Signage Shows Correct Placard

  Media

• Fire Extinguishers in date

  Media

Cylinder Trucks and Utes

• Anti-Slip Material

  Compliant

  Non-Compliant

  N/A

• Complete daily crane log entry

  Compliant

  Non-Compliant

  N/A

• Crane/hoists leak check

  Compliant

  Non-Compliant

  N/A

• Mechanical tail gate is operational

  Compliant

  Non-Compliant

  N/A

• Hook safety latch

  Compliant

  Non-Compliant

  N/A

• Lifting devices (e.g. chains) inspected

  Compliant

  Non-Compliant

  N/A

• Intrinsically Safe Torch

  Safe

  At Risk

  N/A

• DH Emergency Response Guide

  Yes

  No

  N/A

Bulk Tankers

• CoA for Load

  Yes

  No

  N/A

• Flow Meter with Calibration Check Date

• Anti-Slip Material

  Compliant

  Non-Compliant

  N/A

• SFL used when Loading

  Yes

  No

  N/A

• Valves open and shut freely with no leaks

  Yes

  No

  N/A

• Mechanical tail gate is operational

  Yes

  No

  N/A

• Transfer hoses are within expiry dates

  Yes

  No

  N/A

• Hook safety latch

  Safe

  At Risk

  N/A

• Tools are in operational condition

  Yes

  No

  N/A

• Lifting devices (e.g. chains) inspected

  Yes

  No

  N/A

• Adequate spare connectors and tape

  Yes

  No

  N/A

Sign Off

• Driver Name and Signature

  Sign